微种植体支抗同步分别内收前牙加速拔牙间隙关闭的临床研究

摘要

Objective: To investigate the effects and mechanism of microscrew implant anchorage (MIA) in speeding up the closure of extraction space by one step and retraction of anterior teeth. Methods: Twenty-three patients with teeth extraction and required strong posterior anchorage were treated with MIA to close the extraction space. The extraction spaces were closed by two methods respectively. The extraction spaces were closed by the method of one step and retraction of anterior teeth(Ni-Ti spring from MIA to the hook on the wire combined with the elastic pull from MIA to cuspid) on the experiment sides and by the traditional one step method(Ni-Ti spring from MIA to the hook on the wire alone) on the control sides. Which side treated as trial side or control side was selected at random. The period of the space closing, the way and position of anterior teeth movement were observed on each side and the period of the space closing of two sides were tested by paired t test. Results: ①The average period of the spaces closing which was (6.69±1.07) months on the trial side and (9.56±1.19) months on the control side was significantly different (P<0.05).② After the closure of extraction spaces, the cuspid achived better position on the trial side than the contral side on which cuspid presented distal-lingual rotation. Conclusion: The extraction spaces can be closed in all cases by two methods respectively. Using MIA to close the extraction space by one step and retraction of anterior teeth can not only shorten the period of space closing but also achieve nice outcome by moving the cuspid in spongy bone.%目的:探索微种植体支抗配合直丝弓矫治技术同步分别内收前牙加速拔牙间隙关闭的效果与机制.方法:23 例需强支抗的拔牙病例,使用微种植体支抗关闭拔牙间隙,自身随机对照设计,实验侧采用尖牙与切牙同步分别内收关闭拔牙间隙法(即除在后牙区的微螺钉种植体与前牙区的方丝牵引钩间用镍钛拉簧一步法关闭拔牙间隙外,还在微螺钉与尖牙间用橡皮链单独行尖牙远中移动);对照侧则只通过常规后牙区微螺钉种植体与前牙区的方丝牵引钩间用镍钛拉簧一步法关闭拔牙间隙.分别记录两侧拔牙间隙关闭所需的时间并观察前牙移动的位置和方式,SPSS 11.0统计软件对实验侧与对照侧拔牙间隙关闭所需的时间进行配对t检验.结果:实验侧拔牙间隙关闭时间平均(6.69±1.07)个月;对照侧拔牙间隙关闭时间平均(9.56±1.19) 个月;实验侧与对照侧比较差异有统计学意义(P<0.05).实验侧尖牙移动到位后具有更好的生理位置,而对照侧尖牙移动到位后较多发生牙冠远中舌向扭转.结论:微植体支抗配合直丝弓矫治技术同步分别关闭拔牙间隙,在缩短拔牙间隙关闭时间的同时,使尖牙能始终在松质骨中移动,因而前牙内收快,矫治效果相对更理想.